早产的分娩方式——波斯尼亚和黑塞哥维那的经验
Mode of Delivery in Preterm Births - Bosnian and Herzegovinian Experience.
作者信息
Cerovac Anis, Gordana Grgic, Ljuca Dzenita
机构信息
Department of Gynecology and Obstetrics, General hospital Tesanj, Tesanj, Bosnia and Herzegovina.
Clinic for Gynecology and Obstetrics, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina.
出版信息
Mater Sociomed. 2018 Dec;30(4):290-293. doi: 10.5455/msm.2018.30.290-293.
INTRODUCTION
The method of carrying out PTB is one of the most controversial topics of modern perinatology, because there are no clear and undeniable works and studies that would in any case support vaginal delivery (VD) or delivery to the cesarean section (CS).
AIM
To determine more frequent mode of delivery in different groups of birth weights and degrees of prematurity from single and twin pregnancies. To determine the degree of vitality of premature born vaginal delivery (VD) in relation to the cesarean section (CS) in different degrees of prematurity from single and twin pregnancies.
PATIENTS AND METHODS
Research has retrospective cohort character. Data were collected from the databases of University Clinic of Gynecology and Obstetrics Tuzla for the period of five years (January 1st, 2012-December 31st, 2016). The study included newborns of both genders, gestational age from 24 to 37 weeks of gestation (WG) in singleton and twin pregnancies.
RESULTS
Out of 19506 births, 1350 (6.92%) were preterm birth (PTB). Singleton PTB was 1180 (87.40%), and the twins were 170 (12.59%). Vaginal delivery (VD) was born 788 (58.37%). Cesarean section (CS) was born 562 (41.63%). There was statistically significant association between the mode of delivery (MD) in singleton and twins pregnancy in all three subgroups of birth weight (BW) 1000-1499, 2000-2499 and >2500 grams in 33-37 WG. In this group was more frequent VD than CS mode of singleton delivery, and CS than VD mode of twins delivery. In contrast to newborn with BW 1500-1999 grams (chi-square = 23.16, P <0.0001) in same gestational period where was more frequent CS than VD (OR: 2.56, 95% CI: 1.71-3,85). Apgar score (AS) at first and five minute 5-7 and 8-10 in the period 28-32 and 33-37 was a statistically significant frequent in VD and singletons in contrast to CS and twins.
CONCLUSION
VD was more frequent in the higher WG, as well as the higher AS in singletons in contrast to twins delivery.
引言
实施早产分娩的方法是现代围产医学中最具争议的话题之一，因为没有明确且无可争议的著作和研究能在任何情况下支持阴道分娩（VD）或剖宫产（CS）。
目的
确定单胎和双胎妊娠不同出生体重及早产程度组中更常见的分娩方式。确定单胎和双胎妊娠不同早产程度下早产阴道分娩（VD）相对于剖宫产（CS）的生存能力程度。
患者与方法
本研究具有回顾性队列特征。数据从图兹拉大学妇产科诊所数据库收集，为期五年（2012年1月1日至2016年12月31日）。该研究纳入了单胎和双胎妊娠中孕龄为24至37周（WG）的男女新生儿。
结果
在19506例分娩中，1350例（6.92%）为早产（PTB）。单胎早产为1180例（87.40%），双胎为170例（12.59%）。阴道分娩（VD）出生788例（58.37%）。剖宫产（CS）出生562例（41.63%）。在孕龄33 - 37周的所有三个出生体重（BW）亚组1000 - 1499克、2000 - 2499克和>2500克中，单胎和双胎妊娠的分娩方式（MD）之间存在统计学显著关联。在该组中，单胎分娩的VD模式比CS模式更常见，而双胎分娩的CS模式比VD模式更常见。与孕龄相同、出生体重1500 - 1999克的新生儿相比（卡方 = 23.16，P <0.0001），剖宫产比阴道分娩更常见（OR：2.56，95% CI：1.71 - �.85）。在28 - 32周和33 - 37周期间，1分钟和5分钟阿氏评分（AS）为5 - 7分和8 - 10分在阴道分娩和单胎中比剖宫产和双胎更常见，具有统计学意义。
结论
与双胎分娩相比，孕龄较高时阴道分娩更常见，单胎的阿氏评分也更高。
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